Intended for healthcare professionals

Rapid response to:

Letters Irritable bowel syndrome

Why pills more than skills?

BMJ 2009; 338 doi: (Published 06 January 2009) Cite this as: BMJ 2009;338:a3148

Rapid Response:

Hypnotherapy and Cognitive Behavioral Therapy for IBS; The Old Competitors, The New Collaborators

Hypnotherapy and Cognitive Behavioral Therapy (CBT) are the most
studied psychological interventions for patients with Irritable Bowel
Syndrome (IBS). Both treatments have been shown to be effective in
reducing symptoms and improving quality of life in patients with
refractory IBS with long term results up to 5 years [1,2].

While these two
distinct treatments go separately through these years, they could be
integrated to Cognitive Hypnotherapy and perhaps create a more effective
treatment for IBS [3]. IBS patients need to receive cognitive
interventions and hypnotherapy resulted in cognitive changes in parallel
with symptoms improvement in these patients [4]. Meta-analysis showed that
the addition of hypnosis to CBT substantially enhanced the treatment
outcome [5]. So, why not to integrate the two competitors to create a
collaborative strategy? Controlled clinical trials on the efficacy of
Cognitive Hypnotherapy in the treatment of IBS are strongly recommended.

Reference List

(1) Lackner JM, Mesmer C, Morley S, et al. Psychological treatments
for irritable bowel syndrome: a systematic review and meta-analysis. J
Consult Clin Psychol 2004;72(6):1100-13.

(2) Gonsalkorale WM, Miller V, Afzal A, et al. Long term benefits of
hypnotherapy for irritable bowel syndrome. Gut 2003;52(11):1623-9.

(3) Golden WL. Cognitive-behavioral hypnotherapy in the treatment of
irritable-bowel-syndrome-induced agoraphobia. 2007.

(4) Gonsalkorale WM, Toner BB, Whorwell PJ. Cognitive change in patients
undergoing hypnotherapy for irritable bowel syndrome. J Psychosom Res

(5) Kirsch I. Hypnosis as an adjunct to cognitive-behavioral
psychotherapy: a meta-analysis. 1995.

Competing interests:
None declared

Competing interests: No competing interests

28 January 2009
Ali Gholamrezaei
Research Assistant
Mohammad Hassan Emami, Associate Prof. of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, Iran
Poursina Hakim Research Institute, Isfahan, Iran. PO BOX: 81465-1798